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Introduction: Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people. Objective: To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years. Materials and methods: We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults. Results: We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications' mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%). Conclusions: About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.

Introducción. Los fármacos son parte fundamental del tratamiento de múltiples enfermedades. Sin embargo, a pesar de sus beneficios, algunos se consideran medicamentos potencialmente inapropiados en adultos mayores, dado su perfil de seguridad. Las diferencias en los datos epidemiológicos relacionados con los medicamentos potencialmente inapropiados dificultan el establecimiento de sus efectos en adultos mayores. Objetivo. Estimar la prevalencia longitudinal y los tipos de medicamentos potencialmente inapropiados, utilizando los criterios Beers® del 2019 en una cohorte de adultos mayores de 65 años. Materiales y métodos. Se realizó un estudio observacional, multicéntrico, retrospectivo y longitudinal, de cuatro años de seguimiento de los medicamentos potencialmente inapropiados en adultos mayores de la comunidad. Resultados. Se evaluaron 820 participantes de cinco ciudades durante cuatro años (2012 a 2016) en tres momentos (m1: 2012, m2: 2014 y m3; 2016). La edad promedio fue de 69,07 años y el 50,9 % eran mujeres. La prevalencia de medicamentos potencialmente inapropiados en los participantes fue del 40,24 %. El promedio de estos medicamentos entre los sujetos estudiados en el primer momento fue de 1,65 (DE = 0,963), en el segundo fue de 1,73 (DE = 1,032) y en el tercero fue de 1,62 (DE = 0,915). No hubo diferencias estadísticas entre las mediciones (prueba de Friedman, p = 0,204). Las categorías de los medicamentos potencialmente inapropiados más frecuentes fueron: gastrointestinales (39,4 %), analgésicos (18,8 %), relacionados con delirium (15,4 %), benzodiacepinas (15,2 %) y cardiovasculares (14,2 %). Conclusiones. En cerca de la mitad de la población de adultos mayores de la comunidad, se prescribieron medicamentos potencialmente inapropiados de manera sostenida y sin variabilidad importante en el tiempo. Los más recetados fueron aquellos para tratar malestares gastrointestinales y cardiovasculares, analgésicos, para el delirium y benzodiacepinas.

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Under the recently adopted Kunming-Montreal Global Biodiversity Framework, 196 Parties committed to reporting the status of genetic diversity for all species. To facilitate reporting, three genetic diversity indicators were developed, two of which focus on processes contributing to genetic diversity conservation: maintaining genetically distinct populations and ensuring populations are large enough to maintain genetic diversity. The major advantage of these indicators is that they can be estimated with or without DNA-based data. However, demonstrating their feasibility requires addressing the methodological challenges of using data gathered from diverse sources, across diverse taxonomic groups, and for countries of varying socio-economic status and biodiversity levels. Here, we assess the genetic indicators for 919 taxa, representing 5271 populations across nine countries, including megadiverse countries and developing economies. Eighty-three percent of the taxa assessed had data available to calculate at least one indicator. Our results show that although the majority of species maintain most populations, 58% of species have populations too small to maintain genetic diversity. Moreover, genetic indicator values suggest that IUCN Red List status and other initiatives fail to assess genetic status, highlighting the critical importance of genetic indicators.

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INTRODUCTION: Older patients are more susceptible to medication use, and physiological changes resulting from aging and organic dysfunctions presented by critically ill patients may alter the pharmacokinetic or pharmacodynamic behavior. Thus, critically ill older people present greater vulnerability to the occurrence of pharmacotherapeutic problems. OBJECTIVE: To evaluate pharmacotherapy and the development of potential adverse drug reactions (ADRs) in older patients admitted to an intensive care unit (ICU). METHOD: A cohort study was conducted in an ICU for adults of a Brazilian University Hospital during a 12-month period. The patients' pharmacotherapy was evaluated daily, considering the occurrence of ADRs and drug-drug interactions (DDIs), the use of potentially inappropriate medications (PIMs) for older people, and the pharmacotherapy anticholinergic burden (ACB). A trigger tool was used for active search of ADRs, with subsequent causality evaluation. PIM use was evaluated by means of the Beers criteria and the STOPP/START criteria. The ABC scale was employed to estimate ACB. The Micromedex® and Drugs.com® medication databases were employed to evaluate the DDIs. RESULTS: The sample of this study consisted of 41 patients, with a mean age of 66.8 years old (±5.2). The 22 triggers used assisted in identifying 15 potential ADRs, and 26.8% of the patients developed them. The mean estimated ACB score was 3.0 (±1.8), and the patients used 3.1 (±1.4) and 3.3 (±1.6) PIMs according to the Beers and the STOPP criteria, respectively. A total of 672 DDIs were identified, with a mean of 16.8 (±9.5) DDIs/patient during ICU hospitalization. Our findings show an association between occurrence of ADRs in the ICU and polypharmacy (p=.03) and DDIs (p=.007), corroborating efforts for rational medication use as a preventive strategy. CONCLUSIONS: Using tools to evaluate the pharmacotherapy for older people in intensive care can assist in the recognition and prevention of pharmacotherapeutic problems, with emphasis on the identification of ADRs through the observation of triggers and subsequent causality analysis.

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Scholarly research has consistently shown that teachers present negative assessments of and attitudes toward migrant students. However, previous studies have not clearly addressed the distinction between implicit and explicit prejudices, or identified their underlying sources. This study identifies the explicit and implicit prejudices held by elementary and middle school teachers regarding the learning abilities of an ethnic minority group: Haitian students within the Chilean educational system. We use a list experiment to assess how social desirability and intergroup attitudes toward minority students influence teachers' prejudices. The findings reveal that teachers harbor implicit prejudices towards Haitian students and are truthful in reporting their attitudes, thereby contradicting the desirability bias hypothesis. We suggest that teachers rely on stereotypes associated with the students' nationality when assessing Haitian students' learning abilities. The implications of these results are discussed in relation to theories grounded in stereotypes and intergroup attitudes.

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Objetivo: Analisar o uso de medicamentos potencialmente inapropriados (MPIs) e o uso de medicamentos usados em terapia de suporte que requerem cautela em idosos com câncer (MTSRCICs), determinando os fatores associados. Visou-se também determinar a concordância entre os critérios explícitos empregados na identificação de MPI. Metodologia: Estudo transversal com indivíduos com mieloma múltiplo (MM), idade ≥ 60 anos em tratamento ambulatorial. Os MPI foram identificados de acordo com os critérios AGS Beers 2019, PRISCUS 2.0 e o Consenso Brasileiro de Medicamentos Potencialmente Inapropriados (CBMPI). Os MTSRCIC foram definidos de acordo com a National Comprehensive Cancer Network. Os fatores associados ao uso de MPI e MTSRCIC foram identificados por regressão logística múltipla. O grau de concordância entre os três critérios explícitos empregados no estudo foi mensurado pelo coeficiente kappa Cohen. Resultados: As frequências de MPI foram 52,29% (AGS Beers 2019), 62,74% (CBMPI), 65,36% (PRISCUS 2.0) e 52,29% (MTSRCICs). As concordâncias entre AGS Beers 2019 com PRISCUS 2,0 e com CBMPI foram altas, enquanto a concordância entre CBMPI e PRISCUS 2.0 foi excelente. No modelo final de regressão logística polifarmácia foi associada positivamente ao uso de MPI por idosos para os três critérios explícitos utilizados, além de associado à utilização de MTSRCICs. Conclusões: A frequência do uso de MPI e de MTSRCIC foi elevada. A concordância em relação ao uso de MPI entre os critérios AGS Beers 2019, CBMPI e PRISCUS 2.0 foi alta ou excelente. A polifarmácia apresentou associação independente e positiva com uso de MPIs e de MTSRCICs por pacientes idosos com MM. (AU)

Objectives: To analyze the use of potentially inappropriate medications (PIMs) and medications used in supportive therapy that require caution in older adults with cancer, in addition to determining associated factors the agreement between criteria sets used to identify PIMs. Methods: This cross-sectional study included individuals with multiple myeloma aged ≥ 60 years who were undergoing outpatient treatment. PIMs were identified according to American Geriatric Society Beers 2019, PRISCUS 2.0, and Brazilian Consensus on Potentially Inappropriate Medicines criteria. Medications of concern were defined according to National Comprehensive Cancer Network criteria. Factors associated with the use of PIMs and medications of concern were identified using multiple logistic regression. The degree of agreement between the 3 criteria sets was measured using Cohen's kappa coefficient. Results: The frequency of PIM use was 52.29% according to American Geriatric Society Beers criteria, 62.74% according to Brazilian Consensus criteria, and 65.36% according to PRISCUS criteria, while 52.29% of the patients were using medications of concern. Agreement between American Geriatric Society Beers, PRISCUS, and Brazilian Consensus criteria was high, while it was excellent between Brazilian Consensus and PRISCUS criteria. In the final logistic regression model, polypharmacy was associated with PIM use according to each criteria set, as well as the use of medications of concern. Conclusions: The frequency of PIMs and medications of concern was high. Agreement about PIM use between the American Geriatric Society Beers, Brazilian Consensus, and PRISCUS criteria was high or excellent. There was an independent association between polypharmacy and the use of PIMs and medications of concern by older patients with multiple myeloma. (AU)

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Intestine remains the least frequently transplanted solid organ, although the survival and quality-of-life benefits of transplant to individuals with irreversible intestinal failure have been well demonstrated. The trend seen over the past 15 years of fewer listings and fewer transplants appears to be continuing, most noticeably in infants, children, and adolescents. There were only 146 additions to the intestine waiting list in 2022, and the proportion of adult candidates continues to increase, so that now 61% of the intestine waiting list are adult candidates. There has been little change in the distribution by sex, race and ethnicity, or primary diagnosis on the waiting list, or for those receiving transplant. The transplant rate for adults has decreased to 55.6 transplants per 100 patient-years, but the pediatric transplant rate remains relatively stable at 22.8 transplants per 100 patient-years. The decrease in transplant rates for adults is primarily the result of falling rates for those listed for combined intestine-liver, and this is reflected in the pretransplant mortality rates, which are twice as high for candidates in need of both organs compared with those listed for intestine alone. Overall, intestine transplant numbers decreased to a total of 82 intestine transplants in 2022, only one above the lowest ever value of 81 in 2019. No major changes were seen in the immunosuppression protocols, with most recipients having induction therapy and tacrolimus-based maintenance. Graft failure rates appear to have improved at 1, 3, and 5 years for intestine without liver, but this is not seen for combined intestine-liver. Graft and patient survival are better for pediatric recipients compared with adult recipients for both liver-inclusive and liver-exclusive transplant. Rates of posttransplant lymphoproliferative disorder are higher for recipients of intestine without liver.

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BACKGROUND: Brazil ranks second in the absolute number of transplants. However, the supply remains insufficient to meet the demands, resulting in a lengthy waitlist. This study aimed to analyze whether the frequency of human leukocyte antigen (HLA) and the value of calculated panel reactive antibody (cPRA) would influence the waiting time for kidney transplantation. METHODS: The HLA-A, B, and -DRB1 frequencies and the cPRA value were analyzed in 11,186 kidney transplant candidates included in the waitlist from 2006 to 2016. RESULTS: The most frequent alleles were HLA-A*02, HLA-B*35, and HLA-DRB1*13. The overall mean length of stay on the list was 986 ± 1001 days. The mean waiting time for the three most frequent alleles of the HLA-A and B loci showed no significant difference when compared with the least frequent alleles; however, for the HLA-DRB1 locus, the most frequent alleles showed a shorter waiting time. In the association between HLA and PRA, the average length of stay on the list increased according to the candidate's degree of sensitization, regardless of the analyzed HLA frequency. CONCLUSION: The length of stay on the waitlist is influenced by the frequency of the HLA alleles of the DRB1 locus and the degree of sensitization.

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Resumo Este ensaio expõe a disputa em torno do rol taxativo da Agência Nacional de Saúde Suplementar (ANS), promovendo discussões entre os campos do direito e da saúde coletiva através dos documentos jurídicos disponibilizados publicamente. Nos julgados do Superior Tribunal de Justiça (STJ), são extraídas as teses da taxatividade e exemplificatividade do rol. Atravessando ao executivo e legislativo, serão colocados em tela a MP 1.067/21 e o PL 2033/22 (Lei nº 14.454/22), em especial o debate no Senado, evidenciando a atuação do advocacy. Na discussão, a literatura é convidada para contrapor as visões de direito à saúde baseado na verve mercadológica ou enquanto valor social. Demonstra-se que a querela do rol da ANS tem nos julgados do STJ, em 2022, um ponto crítico - e não surgimento. O executivo emitiu medida provisória em 2021 utilizando os argumentos economicistas e tecnocráticos, repetidos pela ANS e pelo Ministro Salomão. O judiciário vinha lidando com o crescente de ações decorrentes de negativas de coberturas, e com um STJ rachado entre as interpretações exemplificativa e taxativa do rol. O legislativo apresentava projetos de lei desde 2008. A atuação do advocacy ressaltou a ausência da saúde coletiva no debate e a ação de grupos motivados por relações individualizadas, transparecendo certo caráter paroquialista. Depreende-se, assim, que os poderes não atuam de forma estanque na definição de políticas de saúde no Brasil.

Abstract This essay exposes the dispute over the comprehensive List of Procedures and health events of the National Agency of Supplementary Health (ANS), promoting discussions between the fields of law and public health, through publicly available legal documents. In Superior Court of Justice (STJ) judgments, the theses whether the list is comprehensive or illustrative are extracted. Crossing to the executive and legislative branches, provisional executive order n. 1067/21 and bill n. 2033/22 will be selected, especially the debate in the Senate, evidencing the role of advocacy. In the discussion section, the literature is invited to oppose the views of the right to health based on market verve or as a social value. It is shown that the dispute over the ANS' list has 2022 as a critical point - and not as an arising point. The executive had already issued a provisional executive order in 2021 using the economistic and technocratic arguments, repeated by the ANS and Justice Salomão. The judiciary was already dealing with the growing number of lawsuits arising from denials of coverage, and with a STJ split between the comprehensive or illustrative interpretations of the list. The legislature has also presented bills since 2008. The advocacy performance highlighted the absence of public health and the action of groups motivated by individualized relationships. It appears that the powers do not act in a watertight manner in the definition of health policies in Brazil.

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Abstract: This study is a systematic literature review of the association between lists of potentially inappropriate medications (PIM) in clinical practice and health outcomes of older adults followed up in primary health care. For this purpose, the PRISMA protocol was used to systematize the search for articles in the PubMed, Web of Science, Scopus, Cochrane Central, LIVIVO and LILACS databases, in addition to the gray literature. Studies with randomized clinical trials were selected, using explicit criteria (lists) for the identification and management of PIM in prescriptions of older patients in primary care. Of the 2,400 articles found, six were used for data extraction. The interventions resulted in significant reductions in the number of PIM and adverse drug events and, consequently, in potentially inappropriate prescriptions (PIP) in polymedicated older adults. However, there were no significant effects of the interventions on negative clinical outcomes, such as emergency room visits, hospitalizations and death, or on improving the health status of the older adults. The use of PIM lists promotes adequate medication prescriptions for older adults in primary health care, but further studies are needed to determine the impact of reducing PIM on primary clinical outcomes.

Resumo: Este estudo revisou sistematicamente a literatura sobre a associação de listas de medicamentos potencialmente inapropriados (MPI) na prática clínica e desfechos de saúde na população idosa acompanhada na atenção primária à saúde. Para tanto, o protocolo PRISMA foi usado para sistematizar a busca de artigos nas bases de dados PubMed, Web of Science, Scopus, Cochrane Central, LIVIVO e LILACS, além da literatura cinzenta. Foram selecionados estudos com ensaios clínicos randomizados, incluindo a utilização de critérios explícitos (listas) para identificar e manejar MPI em prescrições para idosos atendidos na atenção primária. Dos 2.400 artigos encontrados, seis foram utilizados para extração de dados. As intervenções reduziram significativamente o número de MPI e eventos adversos a medicamentos e, consequentemente, nas prescrições potencialmente inadequadas em idosos polimedicados. No entanto, não houve efeitos significativos das intervenções sobre desfechos clínicos negativos (como visitas a serviços de emergência, hospitalizações e óbito) ou melhora das condições de saúde dos idosos. O uso de listas de MPI pode promover a adequação da prescrição de medicamentos para idosos na atenção primária à saúde, mas mais estudos são necessários para determinar os impactos da redução de MPI em desfechos clínicos primários.

Resumen: Este estudio realizó una revisión sistemática en la literatura sobre la asociación de listas de medicamentos potencialmente inapropiados (MPI) en la práctica clínica y los resultados de salud en la población de edad avanzada monitoreada en atención primaria de salud. Para ello, se utilizó el protocolo PRISMA para sistematizar la búsqueda de artículos en las bases de datos PubMed, Web of Science, Scopus, Cochrane Central, LIVIVO y LILACS, además de la literatura gris. Se seleccionaron estudios con ensayos clínicos aleatorizados, incluyendo el uso de criterios explícitos (listas) para identificar y manejar MPI en prescripciones para adultos mayores atendidos en atención primaria. De los 2.400 artículos encontrados, seis se utilizaron para la recolección de datos. Las intervenciones tuvieron una significativa disminución en la cantidad de MPI y eventos adversos de medicamentos y, en consecuencia, en prescripciones potencialmente inapropiadas en adultos mayores polimedicados. Sin embargo, no hubo efectos significativos de las intervenciones en los resultados clínicos negativos (como consultas a servicios de urgencias, hospitalizaciones o muerte) o mejora en las condiciones de salud de los adultos mayores. El uso de listas de MPI puede promover una adecuada prescripción de medicamentos a los adultos mayores en la atención primaria de salud, si bien se necesitan más estudios para determinar los impactos de la reducción de MPI en los resultados clínicos primarios.

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ABSTRACT BACKGROUND: The epidemiology of potentially inappropriate medications (PIMs) in critical care units remains limited, especially in terms of the factors associated with their use. OBJECTIVE: To estimate the incidence and factors associated with PIMs use in intensive care units. DESIGN AND SETTING: Historical cohort study was conducted in a high-complexity hospital in Brazil. METHODS: A retrospective chart review was conducted on 314 patients aged ≥ 60 years who were admitted to intensive care units (ICUs) at a high-complexity hospital in Brazil. The dates were extracted from a "Patient Safety Project" database. A Chi-square test, Student's t-test, and multivariable logistic regression analyses were performed to assess which factors were associated with PIMs. The statistical significance was set at 5%. RESULTS: According to Beers' criteria, 12.8% of the identified drugs were considered inappropriate for the elderly population. The incidence rate of PIMs use was 45.8%. The most frequently used PIMs were metoclopramide, insulin, antipsychotics, non-steroidal anti-inflammatory drugs, and benzodiazepines. Factors associated with PIMs use were the number of medications (odds ratio [OR] = 1.17), length of hospital stay (OR = 1.07), and excessive potential drug interactions (OR = 2.43). CONCLUSIONS: Approximately half of the older adults in ICUs received PIM. Patients taking PIMs had a longer length of stay in the ICU, higher numbers of medications, and higher numbers of potential drug interactions. In ICUs, the use of explicit methods combined with clinical judgment can contribute to the safety and quality of medication prescriptions.

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Colombia depende de la importación de medicamentos, así como de gran parte de los materiales (principios activos y excipientes) requeridos para su elaboración; problemática que genera consecuencias sanitarias y macroeconómicas, las cuales se agudizan en el contexto de desindustrialización nacional y de disrupción tecnológica. De esta manera, se acepta que la disponibilidad y acceso a medicamentos y otras tecnologías sanitarias esenciales son un requisito fundamental para alcanzar la autonomía sanitaria de un país. Por lo tanto, resulta imprescindible coordinar esfuerzos entre diversos sectores sociales para desarrollar una agenda pública enfocada a la creación de condiciones que fortalezcan las capacidades científicas y tecnológicas de la industria farmacéutica local, y con ello, mejorar el suministro farmacéutico del país. En el presente documento se presentan conceptos teóricos y prácticos que deberían ser considerados en la definición y materialización de una política pública encaminada a fortalecer la industria farmacéutica y favorecer la autonomía sanitaria de Colombia.

Colombia has a notorious dependency on the importation of medicines, as well as a large part of the materials (active ingredients and excipients) required for their manufacture. This problem generates health and macroeconomic consequences, which are exacerbated in the context of national deindustrialization and technological disruption. In this way, it is accepted that the availability and access to medicines and other essential health technologies are a fundamental requirement to achieve the health autonomy of a country. Therefore, it is crucial to coordinate efforts between several social sectors to develop a public agenda focused on creating conditions that allow strengthening the scientific and technological capabilities of the local pharmaceutical industry, thereby, improving the country's pharmaceutical supply. This document presents conceptual and practical topics that should be considered to defining and materializing a public policy aimed at strengthening the local pharmaceutical industry and favoring Colombia's sanitary autonomy.

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Changes in land use and land cover (LULC) have significant implications for biodiversity, ecosystem functioning, and deforestation. Modeling LULC changes is crucial to understanding anthropogenic impacts on environmental conservation and ecosystem services. Although previous studies have focused on predicting future changes, there is a growing need to determine past scenarios using new assessment tools. This study proposes a methodology for LULC past scenario generation based on transition analysis. Aiming to hindcast LULC scenario in 1970 based on the transition analysis of the past 35 years (from 1985 to 2020), two machine learning algorithms, multilayer perceptron (MLP) and similarity weighted (SimWeight), were employed to determine the driver variables most related to conversions in LULC and to simulate the past. The study focused on the Aristida spp. grasslands in the Uruguayan savannas, where native grasslands have been extensively converted to agricultural areas. Land use and land cover data from the MapBiomas project were integrated with spatial variables such as altimetry, slope, pedology, and linear distances from rivers, roads, urban areas, agriculture, forest, forestry, and native grasslands. The accuracy of the predicted maps was assessed through stratified random sampling of reference images from the Multispectral Scanner (MSS) sensor. The results demonstrate a reduction of approximately 659 934 ha of native grasslands in the study area between 1985 and 2020, directly proportional to the increase in cultivable areas. The MLP algorithm exhibited moderate performance, with notable errors in classifying agriculture and grassland areas. In contrast, the SimWeight algorithm displayed better accuracy, particularly in distinguishing grassland and agriculture classes. The modeled map using SimWeight accurately represented the transitions between grassland and agriculture with a high level of agreement. By modeling the 1970s scenario using the SimWeight model, it was estimated that the Aristida spp. grasslands experienced a substantial reduction in grassland coverage, ranging from 9982.31 to 10 022.32 km2 between 1970 and 2020. This represents a range of 60.8%-61.07% of the total grassland area in 1970. These findings provide valuable insights into the driving factors behind land use change in the Aristida spp. grasslands and offer useful information for land management, conservation, and sustainable development in the region. The study's main contribution lies in the hindcasting of past LULC scenarios, utilizing a tool used primarily for forecasting future scenarios. Integr Environ Assess Manag 2023;00:1-16. © 2023 SETAC.

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Iochromaorozcoae A.Orejuela & S.D.Sm., sp. nov. (Solanaceae) is described from the Andean forests of Cundinamarca in the eastern cordillera of Colombia. Iochromaorozcoae was first collected by the eminent Spanish priest and botanist José Celestino Mutis in the late part of the 18th century, but the specimens have lain unrecognised in herbaria for over 200 years. The species shares many features with its closest relative, Iochromabaumii S.D.Sm. & S.Leiva, but it differs from it in having small flowers with five corolla lobes and few inflorescences per branch, located near the shoot apex with 1 to 4 (-8) flowers, fruits that are greenish-yellow when ripe and its restricted geographic distribution. A description of I.orozcoae is provided, along with a detailed illustration, photographs of live plants, a comparison with closely-related species and a key to all Colombian species of Iochroma Benth. In closing, we emphasise the value of historical collections for the knowledge of biodiversity.

ResumenIochromaorozcoae A.Orejuela & S.D.Sm., sp. nov. (Solanaceae) se describe a partir de los bosques andinos de Cundinamarca, en la cordillera oriental de Colombia. Iochromaorozcoae fue recolectada por primera vez por el eminente sacerdote y botánico español José Celestino Mutis a finales del siglo XVIII, pero los especímenes han permanecido sin ser reconocidos en herbarios durante más de 200 años. La especie comparte muchas características con su pariente más cercano, Iochromabaumii S.D.Sm. & S.Leiva, pero difiere de esta en sus flores más pequeñas con cinco lóbulos de la corola y pocas inflorescencias por rama ubicadas cerca del ápice de la rama, con 1 a 4 (­8) flores por inflorescencia, frutos verde-amarillentos al madurar, y su distribución geográfica restringida. Se presenta una descripción de I.orozcoae, junto con una ilustración detallada, fotografías en vivo, una comparación con las especies cercanamente relacionadas y una clave para las especies colombianas de Iochroma Benth. Finalmente, enfatizamos el valor de las colecciones históricas para el conocimiento de la biodiversidad.

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INTRODUCTION: Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). Since March 2020, transplant activity in Mexico has been affected due to the COVID-19 pandemic. OBJECTIVE: The aim of the study was to determine the impact on mortality of patients on the waiting list (WL) for cadaveric donor kidney transplantation in a referral hospital in Yucatán, due to suspension of activities due to the pandemic. MATERIAL AND METHODS: Patients over 18 years of age on the waiting list for kidney transplantation at this hospital. In the event of a patient's death, the cause was investigated, especially if it was associated with COVID-19. A two-tailed p ≤ 0.05 was considered significant in all analyzes. RESULTS: The odds ratio (OR) of death from COVID-19 in a patient with ESRD in the WL in 2020 was OR = 5.04 (95% CI: 1.65-7.14, p = 0.023). The OR of dying with ESRD in the WL with a delay in the follow-up visits was OR = 6.59 (95% CI: 2.7-16.28, p = 0.008). CONCLUSION: The probability of death of a patient with ESRD with delayed follow-up visits and transplant retention is statistically higher than the probability of death from COVID-19.

INTRODUCCIÓN: El trasplante renal es el tratamiento de elección de la enfermedad renal en etapa terminal (ERT). Desde marzo de 2020, la actividad de trasplantes en México se ha visto afectada debido a la pandemia de COVID-19. OBJETIVO: Determinar el impacto en la mortalidad de pacientes en lista de espera (LE) para trasplante renal de donante cadavérico en un hospital de referencia en Yucatán, por suspensión de actividades debido a la pandemia. MATERIAL Y MÉTODOS: Pacientes > 18 años en LE para trasplante renal en este hospital. En caso de muerte de un paciente, se investigó la causa, especialmente si estaba asociada a COVID-19. Un valor de p de dos colas ≤ 0.05 se consideró significativo en todos los análisis. RESULTADOS: La razón de probabilidad de muerte por COVID-19 en un paciente con ERT en la LE en 2020 fue OR = 5.04 (IC 95%: 1.65-7.14, p = 0.023). La razón de probabilidad de morir con ERT en la LE con retraso en las consultas de seguimiento fue de OR = 6.59 (IC 95%: 2.7-16.28, p = 0.008). CONCLUSIÓN: La probabilidad de muerte de un paciente con ERT en la LE con retraso en las consultas de seguimiento y retención del trasplante es estadísticamente más alta que la probabilidad de muerte por COVID-19.

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An updated catalogue of Culicoides of Mexico is presented. It includes 86 species with their regional distribution and corresponding record references, known immature stages and associated pathogens. In addition, a taxonomic key for subgenera and species groups for Mexico is presented and an index of species by state is included.

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Background: Harvey Cushing and collaborators created the first society of neurosurgeons in 1920, in the United States of America, the Society of Neurological Surgeons. In 1955, the World Federation of Neurosurgical Societies (WFNS) was created in Switzerland to improve neurosurgical care globally through the scientific cooperation of members. The performance of neurosurgical associations today is fundamental to discuss diagnostic methods and therapeutic approaches, transforming modern medicine. Although most neurosurgical associations are recognized worldwide, there are some societies that are not recognized internationally due to a lack of regulatory bodies and lack of official digital channels, among other reasons. The main objective of the article is to list the neurosurgical societies and to provide a more integrated view of the interactions between neurosurgical societies in different countries. Methods: We developed a table summarizing the countries recognized by the United Nations, the continents, capitals, name of the present societies, and social networks. We utilized "Country AND (Neurosurgery OR Neurological Surgery) AND (Society OR Association)," in English, and in the native language of the country. Our search included: PubMed, Scopus, Google, Google Scholar, and the WFNS website, without filters. Results: We found 189 neurosurgery associations, from 131 countries and territories; 77 countries did not have their own neurosurgical societies. Conclusion: There is a difference between the number of internationally recognized societies, and the number of societies found in this study. In the future, we should better organize neurosurgical societies in countries that have neurosurgical activity with those without such resources.

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There has been just over 30 years of experience in clinical intestine transplant. A rise in demand until 2007 with improving transplant outcomes preceded a subsequent fall in demand due, at least in part, to improvements in pretransplant care of patients with intestinal failure. Over the past 10 to 12 years, there has been no suggestion of an increase in demand and, particularly for adult transplant, there may be a continued trend toward fewer additions to the waiting list and fewer transplants, especially in those needing combined intestine-liver transplant. In addition, over the same period there has been no noticeable improvement in graft survival, with 1- and 5-year graft failure rates averaging 21.6% and 52.5%, respectively, for intestine-alone transplants and 28.6% and 47.2%, respectively, for combined intestine-liver allografts.

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The Critically Endangered southern muriqui (Brachyteles arachnoides) and its sister taxon the northern muriqui (Brachyteles hypoxanthus) are endemic to the Atlantic Forest in Brazil. To date, our understanding of the distribution of the southern muriqui has restricted it to the states of Paraná, São Paulo, and Rio de Janeiro. The northern muriqui occurs in the states of Minas Gerais, Rio de Janeiro, Espírito Santo, and Bahia. Here, we describe the first record of the southern muriqui in Minas Gerais. A group of seven individuals, including one infant, was detected and photographed on  a private property in the district of Monte Verde, municipality of Camanducaia, on the northwestern slope of the Serra da Mantiqueira. This location is 5.3 km from a population of southern muriquis (known since 1994) on the southeastern slope of the serra in São Paulo. This discovery highlights the importance of further surveys in the Serra da Mantiqueira in order to detect any new populations, provide data for a more accurate assessment of the conservation status of the two species-the delimitation of their distributions, the size and extent of isolation of their populations, and the threats they face.

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Increasing the repertoire of available complementary tools to advance the knowledge of protein structures is fundamental for structural biology. The Neighbors Influence of Amino Acids and Secondary Structures (NIAS) is a server that analyzes a protein's conformational preferences of amino acids. NIAS is based on the Angle Probability List, representing the normalized frequency of empirical conformational preferences, such as torsion angles, of different amino acid pairs and their corresponding secondary structure information, as available in the Protein Data Bank. In this work, we announce the updated NIAS server with the data comprising all structures deposited until Sep 2022, 7 years after the initial release. Unlike the original publication, which accounted for only studies conducted with X-ray crystallography, we added data from solid nuclear magnetic resonance (NMR), solution NMR, CullPDB, Electron Microscopy, and Electron Crystallography using multiple filtering parameters. We also provide examples of how NIAS can be applied as a complementary analysis tool for different structural biology works and what are its limitations.

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Introduction: Paroxetine is an older "selective" serotonin reuptake inhibitor (SSRI) that is notable for its lack of selectivity, resulting in a cholinergic adverse-effect profile, especially among older adults (65+). Methods: Paroxetine prescription rates and costs per state were ascertained from the Medicare Specialty Utilization and Payment Data. States' annual prescription rate, corrected per thousand Part D enrollees, outside 95% confidence interval were considered significantly different from the average. Results: There was a steady decrease in paroxetine prescriptions (-34.52%) and spending (-16.69%) from 2015-2020 but a consistent, five-fold state-level difference. From 2015-2020, Kentucky (194.9, 195.3, 182.7, 165.1, 143.3, 132.5) showed significantly higher prescriptions rates relative to the national average, and Hawaii (42.1, 37.9, 34.3, 31.7, 27.7, 26.6) showed significantly lower prescription rates. North Dakota was often a frequent elevated prescriber of paroxetine (2016: 170.7, 2018: 143.3), relative to the average. Neuropsychiatry and geriatric medicine frequently prescribed the largest amount of paroxetine prescriptions, relative to the number of providers in that specialty, from 2015-2020. Discussion: Despite the American Geriatrics Society prohibition against paroxetine use in the older adults and many effective treatment alternatives, paroxetine was still commonly used in this population, especially in Kentucky and North Dakota and by neuropsychiatry and geriatric medicine. These findings provide information on the specialty types and states where education and policy reform would likely have the greatest impact on improving adherence to the paroxetine prescription recommendations.